Bone Marrow Toxicity: White Blood Cells

  • Matti S. AaproEmail author


Chemotherapy-induced febrile neutropenia (FN) may lead to dose reductions and/or delays that may decrease the chances of curative or life-prolonging treatment in patients with chemo-responsive tumors and is related to increased patient mortality. While often associated with a need for hospitalization, this complication can also be treated in an outpatient setting in low-risk patients. Prophylactic treatment with granulocyte colony-stimulating factors (G-CSFs), such as filgrastim (including approved biosimilars and tbo-filgrastim), lenograstim, or pegfilgrastim and lipegfilgrastim, is available to reduce the risk of chemotherapy-induced neutropenia and its consequences, according to the European Society of Medical Oncology (ESMO) and European Organisation for Research and Treatment of Cancer (EORTC) and other guidelines. Prophylactic G-CSF is recommended in patients receiving a chemotherapy regimen with a risk of FN above 20%. Patient-related risk factors (in particular, older age [≥65 years]) may increase the overall risk of FN and need to be evaluated to decide the use of prophylaxis for regimens with intermediate (10–20%) risk of FN.


Granulocyte colony-stimulating factor Filgrastim and tbo-filgrastim Lenograstim Pegfilgrastim Lipegfilgrastim Biosimilars Neutropenia Febrile neutropenia Chemotherapy Guidelines EORTC ESMO 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Genolier Cancer CenterClinique de GenolierGenolierSwitzerland

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